hip arthritis and FAI

Femoro-acetabular Impingement or FAI is a relatively recently recognised condition; it was initially described by orthopaedic surgeon Dr Reinhold Ganz who described the condition in 2003 and identified it as a likely cause for the development of hip arthritis in later life.

The condition affects the junction between the rim of the acetabulum (or hip joint socket) and the femoral head and neck; the socket has a fibrous rim called the labrum, which acts as a shock absorber during movement of the joint.

In an attempt to learn more about the condition, researchers from the Mayo Clinic and China carried out a recent study.

Here, we will look at what Femoro-acetabular Impingement is, how it is treated, the link between hip arthritis and FAI and what the new study revealed.

What is FAI?

Femoro-acetabular Impingement is associated with additional bone growing on the front of the neck, giving it an irregular shape, or on the socket.  This irregular shape causes the neck to pinch against the front of the socket, and this can eventually damage the labrum, causing a tear.  This pinching causes pain, particularly when people twist their hip.

There are different types of FAI you can develop. These include Pincer, Cam, and Combined. Pincer impingement affects the socket, as extra bone forms on the rim, while Cam impingement affects the femoral head. Combined impingement means you have signs of both Cam and Pincer impingement.

Symptoms of FAI include pain, limping, and stiffness. Little can be done to prevent the condition, and it isn’t known how many people suffer with the condition. However, it is known that it mostly affects younger patients.

How is FAI diagnosed and treated?

There are several tests which can diagnose FAI. Imaging tests such as an MRI tend to be the first types of tests carried out. They can help to identify any potential abnormalities or damage within the joint of the hip.

In terms of treatment, it will depend upon the severity of the condition and the symptoms experienced. Corticosteroids can be used to control inflammation, while physical therapy can help to improve mobility and strengthen the joint.  Strengthening the core and gluteal muscles is very important and often all that is needed to relieve patients’ symptoms.

If surgery is required, arthroscopic hip surgery is the most common option. This minimally invasive procedure involves removing damaged bone and cartilage. Open hip surgery can also be carried out, but this is rarely done nowadays.

What did the latest study reveal?

A total of 1,893 patients were involved in the latest study into FAI. It revealed that females have an increased risk of the condition. Interestingly, it also discovered that incidences of the condition increased from 2000-2016. This is largely thought to be down to an increase in awareness of FAI.

Older patients who present with the condition

While there is a link between hip arthritis and FAI, it is uncommon in older patients. Those who present with the same symptoms of FAI, are more likely to be showing signs of arthritis. Furthermore, if arthritis is present, arthroscopic surgery wouldn’t be suitable, as the hip is ‘too far gone’ for this to help.

If you suspect you may have Femoro-acetabular Impingement, book a consultation with Mr Simon Bridle today. While he does not treat FAI, he often carries out MRI testing for patients referred by physiotherapists. Older patients will also be able to determine whether the cause of their symptoms is actually regenerative arthritis, where the only surgical treatment is hip replacement.